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The healthcare market is taxing reproduction out of existence

aaronstannard.com

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Re: The healthcare market is taxing reproduction out of existence

#291

Post by danans »

peter422 wrote: post #112
BeetleB wrote: post #100

Earlier quoted context omitted.

> 15 out of the top 50 and 4/6 top hospitals in the world are in the US Outliers do not say much about the overall quality of healthcare in a country. Rather obvious lesson in statistics. Reminds me of the Russian mathematician who moved to the US after the fall of the Soviet Union. Most of his essays were criticizing American students, but in one essay he was quite frank: Russians who graduate with math degrees are…

Perhaps my language was too imprecise. My argument is that specifically the best care in the US is the best in the world. We have the best doctors and the best technology and the best treatments. This is not completely universal but it is also generally accurate. Whether or not this care is accessible or the median quality is care is good, that is different. I’m just saying we do get something for the money, it’s not…

> 15 out of the top 50 and 4/6 top hospitals

> I’m just saying we do get something for the money

Who is this "we" that gets to be treated at the 15-out-of-50 and 4-out-of-6 top hospitals in the world?

Re: The healthcare market is taxing reproduction out of existence

#292

Post by teeray »

phil21 wrote: post #206
autoexec wrote: post #113

Earlier quoted context omitted.

> but if you dropped all government funding of healthcare tomorrow, healthcare plans would get cheaper. I doubt it. Hospitals charge $15 for a single pill of Tylenol because they know insurance will pay for it, and that includes private insurance. The best thing we could do is ditch the private healthcare industry to the extent that the rest of the first world has and cover everyone with government plans. Those plans…

> Hospitals charge $15 for a single pill of Tylenol because they know insurance will pay for it It’s more they know insurance won’t pay for it, and negotiate discounts based off the “retail” price. Although at this point it’s gotten so ridiculously convoluted and cross-subsidized that I doubt even the insurance company or hospital knows what the actual paid amount for a Tylenol will end up being until months after th…

Meanwhile, I hand my credit card to the vet for a bottle of Gabapentin and I’m out the door.

Re: The healthcare market is taxing reproduction out of existence

#293

Post by tptacek »

Aaronontheweb wrote: post #289
tptacek wrote: post #285

Earlier quoted context omitted.

The logic you're using about out-of-pocket costs versus your deductible appear also not to be valid, and are causing you to misstate your out-of-pocket liability by a factor of roughly 4x.

I can assure you they are, if anything, understated - as I am not including the expenses my health insurance will not cover. So no, you are fully in the wrong there. What do I have to do to prove it? Show you itemized receipts? Moreover, what are you even trying to accomplish by asking for this? Please provide me with a forthright defense of the modern U.S. health insurance markets and why it makes sense for me to ha…

Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.

As for your second question, one easy response is that prospective parents in other health care systems aren't paying less (with everything factored in) but rather differently: that people making your $119k "true" poverty rate in Europe tend to be taxed at their top marginal rate, which is substantially higher than ours (in fact, in a lot of places in Europe, a Chicago Public School teacher would also be paying the top marginal rate).

A thing worth pointing out is that while the system we have is especially punishing on the uninsured, it's actually not that bad a deal for the insured, demographically/actuarially speaking. That's because being insured definitionally puts you in the cohort that excludes Medicaid-eligible poor/working class people and fixed-income seniors. If you move the typical household from that cohort to the UK, they're likely to be worse off. In surveys, insured families tend to be satisfied with their insurance, which is why taking existing health insurance off the table is such a third rail in American health policy.

Anyways, unless you personally are responsible for keeping our population above replacement level (which sounds exhausting), your numbers just aren't probative for the cost of bringing new citizens online. Other numbers might be!

Re: The healthcare market is taxing reproduction out of existence

#294

Post by maxerickson »

BeetleB wrote: post #266
machomaster wrote: post #217

Earlier quoted context omitted.

5GB data cap is ridiculously low. Might as well only count the slow speed.

In over a decade, the only time I hit that cap was because I let my kid watch too many videos on it. 5 GB is pretty reasonable for the bulk of the country. The only common things that can make it go over are games and streaming - both of which really are luxuries if you simply can't wait till you have Wifi access. So yeah - of course you should pay a lot more if you insist on doing those things.

It's like $45-$50 for an 'unlimited' plan that is only capped if you are on a busy tower.

A decent percentage more, not a lot of dollars more.

Re: The healthcare market is taxing reproduction out of existence

#295

Post by a_tartaruga »

ErroneousBosh wrote: post #144
a_tartaruga wrote: post #97

Earlier quoted context omitted.

Home birth is absolutely a rational choice in many cases. The author had a very strong reason to require hospital birth but in scenarios with lower risk it is safer in some respects to avoid the hospital. It will still cost you 5 - 10k for a good midwife and you'll still want to be insured in case you need to transfer. So it only knocks off 5-10k from the total.

Why are you paying to give birth at home when there's a hospital right there, that has all the equipment in case anything goes sideways?

The two biggest benefits are reduction of iatrogenic harm and comfort for the mother delivering.

Midwives are medical professionals who have the equipment and expertise to intervene in the most common scenarios that require it.

Re: The healthcare market is taxing reproduction out of existence

#296

Post by Aaronontheweb »

tptacek wrote: post #293
Aaronontheweb wrote: post #289

Earlier quoted context omitted.

I can assure you they are, if anything, understated - as I am not including the expenses my health insurance will not cover. So no, you are fully in the wrong there. What do I have to do to prove it? Show you itemized receipts? Moreover, what are you even trying to accomplish by asking for this? Please provide me with a forthright defense of the modern U.S. health insurance markets and why it makes sense for me to ha…

Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up. As for your second question, one easy response is that prospective parents in other health…

> Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.

Asked and answered in the piece dude - I wish I had the confidence of a Hacker News commenter who didn't read the article.

Re: The healthcare market is taxing reproduction out of existence

#297

Post by tptacek »

Aaronontheweb wrote: post #296
tptacek wrote: post #293

Earlier quoted context omitted.

Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up. As for your second question, one easy response is that prospective parents in other health…

> Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up. Asked and answered in the piece dude - I wish I had the confidence of a Hacker News comm…

I read the article. It's extremely unclear to me whether you have ACA-compliant health insurance or not. I've been a startup principal since 2005 and have had PEO coverage at various points since the ACA passed, and it was always ACA-compliant. Could you just answer the question? It shouldn't be a riddle!

(Note that "non-ACA insurance" doesn't mean "insurance you didn't buy on the ACA public marketplace". I've got Anthem Blue Cross through our benefits provider. It is very definitely ACA-compliant.)

Re: The healthcare market is taxing reproduction out of existence

#298

Post by hu3 »

izacus wrote: post #136
swalberg wrote: post #98

Earlier quoted context omitted.

Father of 3 here, first two were home births, the third had complications and ended up being a hospital birth. I was initially skeptical for the same reasons but the first meeting with the midwife convinced me that they were taking every precaution and had the training to deal with whatever might come up. The majority of births are simple if you let them be and the midwives go to great lengths to make sure the condit…

Is this mindset the cause of US skyrocketing child mortality?

ikr.

They rather try their luck at home than leverage a thousand years of medical research that culminates in hospitals.

Not once but 3 times. I'd be pissed knowing my parents put me through such unnecessary risk.

Re: The healthcare market is taxing reproduction out of existence

#299

Post by tptacek »

Aaronontheweb wrote: post #247
bonsai_spool wrote: post #222

Earlier quoted context omitted.

> And "manipulating your income" is not really feasible with a pass-through entity. I don't know if you have a CPA, but this is a sentence my CPA has never uttered. > but by simply refusing to cover the care those applicants need to survive pregnancy (legal and common.) Including...? I have never heard of this, and actually have delivered babies and worked with post-partum mothers.

The explanation of benefits simply doesn't cover child birth - this is extremely common for individual marketplace plans.

If by "individual marketplace" you mean the Healthcare.gov-style ACA individual marketplace, you now know this to be totally false.

Re: The healthcare market is taxing reproduction out of existence

#300

Post by barbacoa »

postflopclarity wrote: post #234
xyzelement wrote: post #209

Earlier quoted context omitted.

What does that mean? Plenty of people have been conceived in the backseat, and some in the front. But seriously, what are you talking about?

car-dependent infrastructure and urban design is hostile to human life.

Car depend infrastructure is amazing to families. A mom can take her children to the grocery store in a car in relative safety without worrying about mentally ill homeless people on the subway.
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